Chapter 36 - Stroke in Young Adults

Abstract

Stroke is the third leading cause of death in the United States, accounting for 1 in 15 deaths in 1998. According to recent estimates, there are at least 700,000 new or recurrent strokes per year in the United States, with 150,000 deaths. Although the stroke death rate fell by 15% over the decade between 1988 and 1998, the actual number of strokes rose more than 5%. Stroke is the number-one cause of disability in adults. Stroke is defined by the World Health Organization as rapidly developing clinical signs of focal (or global) disturbance of cerebral function, with symptoms lasting 24 hours or longer or leading to death with no apparent cause other than of vascular origin. Stroke in the young generally is classified as stroke occurring in people between 15 and 45 years of age. However, some studies have used an upper age limit of up to 50 years or have made further divisions that analyze those 31 years or older and those 30 years or younger separately. Strokes in young adults account for approximately 3% to 10% of all people with stroke. Stroke in the young is more common than once suspected. The incidence of stroke in this age group is higher than that of multiple sclerosis among young women. This review is concerned with ischemic stroke in the young. The topics of coagulopathies, vasculitis, and subarachnoid and intracerebral hemorrhages are discussed elsewhere in this text.